Moral and Legal struggles of Medical Marijuana Melisha

Moral and Legal struggles of Medical Marijuana Melisha Hamm Duncan Ruchisha Patel Sthefany Torres Jessica Miles Minal Gandhi Karolina Lira Vidya Patil Mounia Derkouch

What is the Ethical Dilemma?

Should Physicians be allowed to prescribe Medical Marijuana? Yes and No For or against? Ø Journal of Family Practice Must be medical use only v Patient must be given recommendation v Treats more than just cancer; v Aids/HIV v Anxiety v Pain Management v Glaucoma v Eating Disorders

Should patients have a right to request Medical Marijuana? Public view has always favored the use of medical marijuana Pros and Cons Risks Patient vs. Physician v v Right to receive medical information Qualification process

Political Views Federal Government For or against ? v Approval of certain states v Republicans 63% in favor Democrats v 77% in favor

Medical Marijuana: The Facts

Marijuana: The Facts What is Marijuana? Ø Cannabis subspecies: § Ø C. sativa, C. indica, C. ruderalis Cannabinoids: § § Tetrahydrocannabinol (THC): psychoactive Cannabidiol (CBD): non-psychoactive

Marijuana: The Facts How does Cannabis work on the human Body? ØEndocannabinoid System (ECS) ØCB 1 (brain) and CB 2 receptors (immune system cells) http: //www. 21 stcentech. com/biomedicine-part-11 -curing-technologies-in-the-21 st-century-overcoming-addiction/

Marijuana: The Facts Cannabinoid Bioavailability Methods of administration Ø Ø Inhalation ( vaporizer, “e-cigs”) Smoke (“joints”, “blunts”, cigarettes) § Ø Smoking topography Ingested (edible treats, raw juicing) FDA-Approved Drugs with synthetic cannabinoid Ø Marinol (dronabinol)

Marijuana: The Facts Risks Associated with Marijuana Ø Ø Increased heart rate Changes in blood pressure Psychosis Smoking is detrimental to respiratory system Outdoor vs. Indoor Grows Ø Contaminants

Define the Stakeholders

Highest level Stakeholder “Government” Federal vs. State vs. Local Marijuana is classified as a Schedule I substance under the Controlled Substance Act Marijuana is being shipped to other states (Oklahoma and Nebraska) from Colorado making it harder for officials adding more work.

Mid-level Stakeholder “Physician” q First Amendment allows Physician Patient Communication q Physician has to recommend and prescribe the use of Medical Marijuana for its patients

Effective Stakeholder “Patients” Patients must have a qualifying medical condition to obtain state or county issue ID card. q Each state has its own list of specific medical conditions or symptoms in the Medical Marijuana Law q q q Cancer, AIDS, Multiple Sclerosis, Sever/Debilitating Pain, Sever Nausea Certain states allows patients to enroll in state-run medical marijuana programs to gain help from caregivers to grow the plant

Options and Alternatives

Alternative Treatments for Pain Management Acupuncture Exercise Chiropractic Manipulation Supplements and Vitamins Therapy Stress-reduction techniques u u u u Yoga Relaxation therapy Hypnosis Guided imagery Music therapy Biofeedback Massage

Alternative Treatments for HIV/AIDS More than 25 antiretroviral drugs to treat HIV infections that lower viral load and help fight infections. Massage Dietary Supplements Meditation Acupuncture Ø Ø Anxiety Eating Disorders

Alternative Treatments for Epilepsy o o Herbal Medicine Relaxation and biofeedback Acupuncture Chiropractic therapy v Charlotte’s Web

Alternative Treatments for Cancer u Alternative treatments may not play a direct role in curing cancer, however they do help cope through the signs and symptoms caused by cancer and cancer treatments.

Make a Choice/Decision

Lets have a vote in the class? How many of you are for it? How many are against it?

Making a Choice Facts of what we gathered THC and CBD, marijuana’s primary cannabinoids, are both cancer killers. Suicide rates are lower in areas where medical marijuana is available. So far there is ZERO evidence that marijuana causes significant damage. Regulating and taxing will generate revenue and boost economy.

Our Decision Based on the facts, as a group we are pro Marijuana WHY Ø Ø Legalizing it will give us the opportunity to do more extensive research to create more effective dosages and isolate the ingredients to create more medicine It will reduce crime, suicide, and DUI’s. Giving cancer patients an alternative medication besides just using chemo. Medications like volume and oxytocin are addictive with many side effects , marijuana would not harm patients with such side effects.

Since we are talking about Marijuana here a few pictures form our recent San Diego trip!

Justify your Choices

Medical/General Justification Natural Herb Has a long history of use FDA has tested and approved certain components

Case - Zaki Jackson Rare form of epilepsy 100 s of seizures a day Tried various medications Finally marijuana relieved the kid

Legal Justification Marijuana Regulating and taxing will generate revenue Reduced crime, violence, and corruption due to involvement of international drug markets Venture capitalists ready to invest will boost economy Shipped from legalized states to other

Political Justification Increased support for Marijuana Many states have legalized considering the benefits of the marijuana Political parties asking for lesser punishments vs. opposing Various restrictions on the dispensing of marijuana

How can this Ethical Dilemma be prevented?

Legal Struggle Conflicts between local, state, federal to be available to the public: Ø It is challenging the essential fundamentals of the acknowledged practice in the medical, legal, and ethical societies The primary antagonist to legalization; The federal government Outdo state law rights by frightening patients and physicians with criminal prosecution Ø Local, state, and federal strongly argue that Schedule I drugs has a high potential for abuse

Legal Struggle Cont. However, is it truly gaining the public support to outlaw it? Ø Huge public support in some states to ban it Ø Ex, Montana and California Ø Is the public fully aware of the advantages and disadvantages of medical marijuana? The central opposition: the federal government Ø A national policy of “zero-tolerance” toward illegal drugs

Moral Struggle The Ø Ø ethical dilemma: If banned, will it be violating the physician-patient relationship? Is it true that, it can be enclosed by the ethical moralities of autonomy and beneficence? Are not patients having the right to expect full disclosure and discussion of all available treatment options from their physicians? Is it considered violating the basic duty of a physician, if denying a patient that has a terminal disease?

Practical Consideration The use of cannabis as a medicine can bring up lots of questions: Issue with reimbursement – Health Insurance

Recap The Purpose of marijuana Limited medical researches The stigma

Citations § http: //www. whitehouse. gov/ondcp-fact-sheets/marijuana-legalization § http: //www. pewresearch. org/fact-tank/2015/02/27/63 -of-republican-millennialsfavor-marijuana-legalization/ § http: //medicalmarijuana. procon. org/view. answers. php? question. ID=1325 § http: //www. lawteacher. net/free-law-essays/medical-law/outline-is-the-legalizationof-medical-marijuana-morally-sound-law-medical-essay. php § http: //www. ncbi. nlm. nih. gov/pubmed/10754797: The ethics of medical marijuana: government restrictions vs. medical necessity. § http: //www. ncbi. nlm. nih. gov/pmc/articles/PMC 3628147/: Medical marijuana: Medical necessity and political agenda. § http: //www. cdph. ca. gov/programs/MMP/Pages/MMPFAQ. aspx § http: //www. nytimes. com/2014/12/29/us/pot-pie-redefined-chefs-start-toexperiment-with-cannabis. html? _r=1

Citations Cont. § http: //www. ncbi. nlm. nih. gov/pubmed/19296351: Medical marijuana: the conflict between scientific evidence and political ideology. Part one of two. § http: //www. csatc. org/cellularbiology. html http: //www. mpp. org/search. jsp http: //www. ncbi. nlm. nih. gov/pubmed/10754797. The ethics of medical marijuana: government restrictions vs. medical necessity. http: //www. ncbi. nlm. nih. gov/pmc/articles/PMC 3628147/: Medical marijuana: Medical necessity and political agenda. http: //www. ncbi. nlm. nih. gov/pubmed/19296351: Medical marijuana: the conflict between scientific evidence and political ideology. Part one of two. http: //www. insurancequotes. org/health-insurance/healthresources/medical-marijuana-coverage/: Medical Marijuana and Your Health Coverage. § § §

Questions